A recent survey on physician burnout and stress found that, perhaps unsurprisingly, physicians cited electronic health records (EHRs) as the top factor contributing to stress, followed by dealing with payers and pre-authorization and then regulatory compliance.
Reaction Data, a market research firm focused on the healthcare and life sciences industries, surveyed 254 physicians across the country in a wide variety of specialties about what factors contribute to physician burnout. Twenty-one percent of respondents cited EHRs, followed by payers/pre-authorization (19 percent), regulatory compliance (18 percent) and internal bureaucracy (17 percent). And, these factors all have a common theme: they are time consuming and prevent the physician from providing care for the patient.
Other burnout factors cited by respondents included work/life balance (11 percent) and malpractice risk (6 percent).
Patients, not surprisingly, were only mentioned by 2 percent as causing an undue burden. The survey report cites one orthopedic surgeon who commented, “Our current healthcare non-system needs to be radically changed. Way too expensive and chaotic. Profit must be eliminated.”
Across different specialties, EHRs were consistently cited as a top burnout factor, although, surgeons and physician leadership cited payers/pre-authorization as a bigger burden (22 percent and 24 percent, respectively) than EHRs (20 percent).
When asked how EHRs could be improved to reduce the burden, one-third of respondents (34 percent) cited improving user-friendliness. According to the survey report, one pediatrician suggested that EHR vendors “Create one by and for physicians, not administrators and technogeeks.”
Another respondent, an orthopedic surgeon, commented, “Develop a better and more user friendly EMR. It shouldn’t take 20 minutes to do something that dictation takes three minutes.”
Seventeen percent of respondents would like to see vendors add dictation and scribe features to EHRs, 13 percent would like to spend less time documenting in the system, and 9 percent suggested replacing or getting rid of EHRs. Other suggestions to reduce EHR stress included reducing clicks (7 percent), more physician input (7 percent), focus on patient outcomes (6 percent), improve interoperability (4 percent) and additional training (3 percent).
Overall, the survey results indicate that physicians want an easier system with dictation features that reduces the time required in the system. “They want more face to face time with the patient, rather than staring at a monitor and a keyboard,” the report authors noted.
“The nurses and medical assistants need to be able to put more of the data into the EHR, permitting the doctor to spend more time with the patient,” one gastroenterologist and survey respondent said.
The survey results also indicate that EHR stress appears to know no brand name loyalty. Of those who said EHRs are one of their main causes of stress, 39 percent are using Epic, 18 percent use Cerner, 11 percent use Allscripts and the remaining respondents use athenahealth, Meditech, NextGen, eClinicalWorks and GE.
One respondent, an emergency medicine physician, commented, “EHR seems to be predominantly a billing tool, secondarily a compliance tool. Start over and design EHR for patient care. Too many boxes to click, too many irrelevant alerts, soft or hard ‘stops’ (best practice alerts in Epic), create alert fatigue. Very little useful clinical decision support.”
Physicians also cite regulatory burdens as a contributing factor to burnout and stress. Thirty-seven percent of respondents would like to see fewer rules, 32 percent would like to see more simplification and 15 percent said more physician input was needed.
According to the report, one chief medical officer recommended shifting reporting to an automated system that retrieves data from the EMR rather than manual reporting. A CMIO added, “Get rid of what seems to be unnecessary regs that don’t contribute to patient care or quality of care.”